Ep 327: Understanding Holistic Dentistry & Myofunctional Therapy

Hello and welcome to episode 327 of the Untethered Podcast. I am your host, Holly Balkan and today I am so excited to be here welcoming somebody who's not only a dear friend but also one of the most brilliant, passionate and forward thinking minds in holistic dentistry. And that, my friends, is Dr. Jennifer Tippograph. Jen is a proud native of Washington D.C. and her journey into dentistry is both inspiring and deeply intentional. After earning her Bachelor of Science from Virginia Tech, she began working under the mentorship of Dr. Kimberly Baer at Natural Dentist Associates. That's where her love for holistic dentistry and her commitment to treating the body as an integrated whole was born. She then went on to graduate school and graduated third in her class, first female in that spot from Howard University College of Dentistry. Since then she's become a certified provider with the International Academy of Oral Medicine and Toxicology. Trained in the safe mercury amalgam removal technique and skilled in advanced growth appliances like the DNA, LIAO and alf as well as holistic implantology using metal free zirconia and regenerative techniques like PRF. Dr. T doesn't just keep up with dentistry though. She elevates it. Through hands on experience, ongoing education and a whole body approach to care, she is transforming the way patients experience dental health. As for me, you guys know me, it's a shared episode so I'm not going to spend too much time talking about myself. But I'm an slp, a speech language pathologist by trade, business mentor, feeding therapist, myofunctional Therapist and founder of several programs like Feed the Peds, a Certified Pediatric Feeding Therapist certification, the MYO method, the MYO membership, the CMT certification for myofunctional Therapists, you know, to help assess and treat orofacial myofunction disorders. So all things feeding in MYO and I basically help SLPs, OTs, PTs, dentists, you know, dental hygienists. Become confident in your pediatric feeding and or myotherapy spaces while mentoring clinicians in building online businesses as well. So together Jen and I actually wrote a series of books of kids books. We've swapped some big ideas and today we are bringing our shared passion for integrative care strength straight to you. Let's dive in. Welcome to the Untethered Podcast. I am your host Holly Balkan. I'm a certified myofunctional therapist, feeding specialist, podcaster, business owner and mentor. This podcast is all about getting your questions answered and collaborating with colleagues to bring you the most up to date information in the orofacial myofunctional therapy, airway, tethered oral tissue and pediatric feeding therapy space. If you're new here, I challenge you to keep an open mind and join my mission to spread this message far and wide. If you've been around since June 2019, thanks for being a loyal listener. As we jump into today's episode, remember to listen with correct oral rest. Posture, tongue up, lips closed, teeth apart.

Breathe through your nose.

Let's get started. Quick disclaimer. All information, content and material of this podcast are the opinions of the speakers and is for the informational purpose only and not intended to serve as a substitute for the consultation, diagnosis and remedy, medical treatment of a qualified healthcare provider. Hey, Jen, welcome to the podcast. Hi. How are you?

I'm good. How are you?

I am good. So for everyone who does not know, Dr. Jennifer Tippograph, she's a dear friend and colleague of mine and she has been on the podcast. I think what you were like episode number four or something. Is that right back when. Yes, back in 2019, when I started all of this. And since then we've done a few things. So before we jump into that, give us a little bit of a background about, like, who you are and what you do and then we'll dive in.

Yeah. Thank you so much for having me. I'm happy to be back. So I started off actually as a dental assistant before I went to dental school at the practice that I am currently at, holistic dental practice, and then went to dental school, came back, started working as a holistic dental, you know, like after being a dental assistant, working as a dentist at the same dental practice, I went and got training with the iomt, which is the International Academy of Oral Medicine and Toxicology. Super passionate about all things holistic. I'm a holistic mom. I practice what I preach. But in terms of, you know, the practice I. We take into account the mouth is connected to the rest of the body, which is super important. So that addresses certain dental materials. Airway, you come in, we're talking to you about your supplements, your sleep, all of it. So it's just, it's very. It's very cool. I love it. Very, very into it.

I love it, too. That's why, you know, that's why we get along so well. And you guys all know me, so I don't give like a whole background on myself, but slp, feeding therapist, myotherapist, you know, definitely in the airway health space. Very holistic as well. And yeah, Jen and I have Known each other. It's really funny because, like, our daughters, we were talking about this. We met when we were in first grade, and we now have. Or not. Was it first grade? Second grade. Yep, second grade. And we now have daughters going into second grade, which is absolutely wild. But today we're going to share, like, the what, the why, the how behind these little books sitting here behind me. Our children's book series on tongue ties, myofunctional therapy and Frenectomy. And so, you know, let's just. Let's jump right on into that, because I know a lot of people have been asking us, you know, what inspired you guys to, like, create this series? I don't know if you want to start, Jen, but, yeah, very cool.

I went in as the mystery reader for Gabby's class, and they were. It was the first time they'd had a mystery reader that was also the author, which was very cool. But they were being taught how to write and how to illustrate. So that's also where some of these questions came up, like, well, how'd you do it?

What did you do?

Blah, blah, blah, you know. So you and I started writing them probably at this point, because Mo's turning five this weekend. So probably like five and a half, six years ago, you and I would meet in, like, these coffee shops, basically, in Bethesda that I don't even think they exist anymore, honestly. And we would just start writing because you and I thought that there was a need for this. I mean, there was. There was nothing out there to talk to parents, to kids, and, you know, just kind of bring it down to a level that people understood. So you and I started writing, and then you moved to Florida. And then we would, you know, meet virtually and, you know, just start adding and editing. And then we hired the illustrator, and the rest is history, basically. But it was a. It was a cool process. You know, it took some time and. But it's obviously worth it. You know, we. We have this great product now.

Yes.

Yeah.

And I think, you know, just to, like, you know, echo what you said, it was like there wasn't anything out there. And I kind of like, in my brain, I was like, let's normalize this conversation, because we know there's so many kids, they don't really get it.

They.

They don't even understand that their tongue is stuck. Right? They don't understand that their tongue should be able to do other things. Like, you have adults who don't understand that. Cause that's just what they know. It's how they've lived their whole life. So I was like, if we can like bring this into like a fun little story and get kids like comfortable with the conversation and the topic and even introduce this concept to parents, you know, like, how cool would that be? And now I feel like there's been other books that have come out, like, related, not exactly the same as what we've done, but I'm like, oh, if we could have like a section in the library or the section at Barnes and Noble. You go to Amazon and there's like books right on these topics. Like, how cool.

Yeah. And I, and I do think we're getting through because we like the other day I went to this like play based place with the kids and we were playing like vet, for example, and Mo's like, mommy, there's a guitar string under, you know, this cat's tongue. And I was like, okay. But I was like, whoa, you just. You got it. Like you understand now. And it was very cool to see it actually translating, you know, into understanding.

I love that. I love that. I feel like after having worked like in. Because I was really working primarily with kids and some adults in the myo space, but primarily kids with like speech and feeding and then mayo and everything, it was like the same thing. Like it just wasn't clicking and, you know, it was sort of like, how do we normalize this? So I would tell them like a little story or we would make it really playful and, you know, and I think that's when like you and I were like, wait, we need to like, we need to like, write some kids books. I was like, yes, life got in the way a few times. It kind of got put on the back burner. But five and a half years later, here we are.

Yeah, I love it. And it's cool because now like our kids are reading the books to us.

Yes.

Yeah.

Isn't that wild? That is so funny. I was running a call for my feeding course last night and it's the TOTS module week and so we're talking about tongue tie and this question came up and it's funny because I didn't even think like, oh, have them read these books. But like, hi, I'm going to go back and tell them that now. But someone was like, how do you prep a kid for a frenectomy? Like, how do you prep them to do that? Active wound care and the exercises afterwards, you know, And I just started giving the whole laundry list of things. I was like, you've got to make it playful. You've got to normalize the conversation, talk about it before, make sure that they're used. Do it before they go for the procedure so that it's not something new after. Like, do it in a mirror, maybe. Let them hold the phone. They're going to want to see what's going on, because it's like you're going in their mouth, and that can be scary. Right. But also let them do it on you while you then, you know, it's like, everyone take turns, you know? So I'm like. To have, like, these books as tools in addition to all these other things we can do. I'm like, it just makes things easier.

I mean, you and I both know that it makes the treatment that much more effective.

Totally.

I mean, yes.

So, yeah. And, like, I want kids to understand, like, their bodies. I want them to understand, like, this is your tongue. Your tongue. It connects here and here and here and here, all the way down to our toes.

This is connected to the rest of the body. That's what I. I mean, we talk about all day with people, like, upper jaw with the eyes, the lower jaw with everything else, you know, and people will come in, and I think you notice, like, we co. Treat three times a week with a pt. We, you know, we value the importance of the bodywork and the input we get from these pts, because one's like an osteopathic pt. The other one utilizes, like, counterstrain and postural restoration, like, all these different modalities that they're using to help assess the patients. And it's such valuable feedback to see how everything's connected. I mean, it's just. It's. And people do appreciate it. They're like, whoa. How did you know my left shoulder was tight? Like, you know.

Yeah, yeah, I know. I. I was treated by one of them. And he would go down and, like, he'd, like, pinpoint something. He'd go to my head, right, with the brain mapping, and then he'd go down to my leg, and he'd be like, do you feel that? I'm like, ow. I'm like, how did you know to go right there? Like, you go two, like, millimeters to the left. And it doesn't. Like, I can't feel it, but he goes in that one spot. And I was like, that is wild. It is so very cool to, like, see how it is, again, also interconnected. So is there anything that you wish, like, parents or even children would know before, like, they see you in the dental chair? Cause I feel like you have a very different kind of holistic approach in office. So you guys are obviously looking at everything when someone comes in there just for a cleaning and sitting in your chair.

Yeah, well, I mean, you know, I feel like a lot of people do come in educated nowadays because of, you know, social media or online or people are reading. I mean, you know, people are educating themselves. They're coming in more aware than they did probably some years ago. But there are some people that are still learning. I mean, look, we're all learning, we're all growing, you know, so some people will come in. And no matter if you come in knowing a lot or a little, I, I, I talk to the patients, I sit them down, I say, okay, like, give me a little bit of why you're here. We discussed that. And then I start going through, like, their medical history, their dental history. We spend a while going through that because it allows me to understand the full picture. So while I wish maybe there were a few things they would come in with more, I feel like it's hard to say because people do come in pretty educated. But if they don't, it allows me the opportunity to educate, which is nice. Like, there's little things like I talk to people about because, you know, anytime you eat or drink anything that's not plain water, it can change the ph in the mouth. So, like, it's great. Our kids snack on an apple. You know, I talk to people about, like, nuts, carrots, like, raw foods, you know, the chewing aspect of things. Like you. And I've talked about, like, pouches versus real food, you know, and look, time and a place for everything. But like, you know, it's just, it's important that people understand, like, for example, their child goes, or they even go to eat an apple, it's still sugar. Take the water you're drinking and just switch it around and swallow. Just like little things. But, you know, those things can add up. So, I mean, I do appreciate, you know, and I do appreciate when people come in, but at the, you know, knowing stuff, but at the same time, like, I, I love what I do. And I'm happy to, like, sit there and talk all day about, you know, certain things we can improve on. And, you know, it's also knowing, you know, how much and how little. And, you know, because some people would want to just do step by step and that's fine too. But treating, you know, the whole person is, it's just, it's, it's very rewarding. It's great.

Yeah, yeah. No, it's always very interesting too like when I talk to my team and they're like, I was talking to this parent and I asked them about sleep and they're like, well, why are you asking about sleep? My kid's here for speech or for feeding. And they're like, cause it's all interconnected. And when you start to talk about the nervous system and how that's impacted by how we're breathing, how we're sleeping, how we're chewing, how we swallow all the things, it's sort of like parents kind of this light bulb goes off and they're like, oh, well, no one's really ever talked to me about that before. But to that same token, the practice is getting more people who come to us because they know what we do. They know, like, we're more holistic. They're like, okay, I've heard you help this kid. Or I know that you guys look at these things. Like, you know, we're like, yeah, I'm using. Right. Not every parent, there's still a lot of educating that we do, but on, you know, but we're also not a holistic, like, dental office. So a little different. But no, I think it's really cool though that I do feel like there is education happening, because that was like one of my big dreams, like six, seven years ago. I was like, if we could just like make this conversation more mainstream. And at that point I feel like. I was like, I feel like we're at least 10 years away from that. But I, I feel like I've seen a little shift where people are sourcing their own information, doing their own research. Like, there's obviously so much to like sift through out there and even knowing who to listen to and what to believe and all that. But I think a lot of parents are very intuitive, especially when they're in the holistic space. And so it's very cool to see it, like, kind of coming.

Yeah, I feel like you probably see it with your people that are coming to you. Like most people, like, we see they're open minded. Like, they're open to learning, to making change, you know, And I get it. Like, sometimes it's not the right timing if you're not open to making it, but it's just all about, like, providing people with the tools so they can function well and they can thrive and it's a beautiful thing.

It is, it is. Yeah. All right, so let's talk about the books. Yeah, so let me grab this one. My tongue. Oh my goodness, my tongue is stuck. So in a nutshell, this one's about like a child who starts to notice that their tongue is just different. Right. It's not. It's not functioning the way. And they can say that it's not functioning like the way it should, but they're basically like, my tongue is stuck.

Right.

And so I think that kind of lends well to the conversation about, like, certain symptoms, like, you know, sleeping with your mouth open, maybe having trouble producing speech sounds because the tongue can't actually hit the articulation targets. Well, picky eating because the tongue can't move the food around or help you create that ball of food that's ready to swallow the bolus, you know, but it's like we take a lot of this and without like even really talking so deeply about all those symptoms, like, we just kind of make this kid friendly story where it's like, hey, the tongue is not working. Oh, but we're going to go visit Dr. Teeth tomorrow for a dental cleaning. Let's go talk to Dr. Teeth.

And going back to what you said, it's allowing Nora in the book to become self aware.

Yes.

And she is communicating in the book with her mom. So it's like getting the mom aware, you know, they're like talking, you know, during brushing teeth, which is also a good time for parents to talk to kids because you're already there. It's not sort of like, oh, bringing it up randomly, you know, it's like, oh, can you, can you do that with your tongue? You know, and just slowly, just, you know, one step at a time, talking about it, explaining, exploring it, all those things that you had previously mentioned.

Yeah. And I know we worked like, really hard to, like, get the images to like, the point where it was like, I want them on being like, hey, can you move your tongue over here? How about here? Can you go up, down, side, side, all around, like. And you know, she's like, I can't do that. This is hard. You know, which I think is also very relatable because a lot of kids just kind of shut down if they can't do something initially. You know, they're kind of like, I don't want to do that exactly. Like, I don't like that. They're not going to be like, that's too hard for me. I don't like it. Just like, no, I'm not doing that. So I think that whole, like, self awareness that you mentioned is so, so important because I feel like kids are going to read this. Right. And even some of, like, my kids are reading it and they're kind of going like, ah, I can do that. They're trying to, like, copy the book. And I'm like, oh, becoming a little more self aware about, like, what our tongue can and can't do. How cool is this?

Yes. Yeah.

So what do you think? Like, okay, so how do you think that we talk to kids or even parents, maybe if parents are listening or other providers without, like, scaring them or making them feel like they're broken? Because, like, there's, there's nothing wrong with them.

Right.

It's just like, different. Do you have any thoughts on that?

It's like, we just want to help optimize function. We want to help optimize growth, optimize, you know, their speech, their swelling, like you said, their sleep. So I think, you know, just gentle exploration basically, you know, while they're brushing their teeth or say you're like, driving in the car and they're in the backseat with that open, resting mouth posture, you know, like, hey, you know, can you, can we play a game together? Let's, you know, try to, you know, like, what do you mean? This is probably a good segue into the next book about, like, the myofunctional therapy. Like, can you, you know, blow bubbles or, you know, put your tongue side to side or can you show me how you breathe through your nose? Just make it fun. And that's what I've tried to do with, like, my own kids. Like, one little thing that I do and you can talk more on this is like, sometimes at like the end of the meal, if there's like just a little bit, not to say that they're like messy eaters, but if there's just like a little at the corner, say it's something, you know, they're eating or drinking. I'll be like, can you, you know, go like that? Just to kind of clean it up before I reach for the napkin or whatever, you know, and just trying to like, make it basically so it's, it's non invasive.

Yeah, I love that. I mean, and I think that's, that's, that's a thing that we do though, right? Like, we use our tongue as adults to clear our lips or to get like food off our face if it's reachable with our tongue. And I think a lot of kids, you know, don't. Nobody really knows outright that they're even doing it. It's so, like, reflexive or like second nature to us. And we're not going, oh, let me take my tongue and put it over there. And try to clear that up.

Okay, let's go.

Right. No, it's like you just do it without thinking about it. But then people who physically can't, because they're restricted, they don't do it right. So then they are wiping a lot more. They're. And they're not realizing that they're compensating. So I think you make like a really good point because again, it comes back to like that, that awareness of, you know, what we should be able to do. But then also, you know, with this whole conversation around myo just, I think bringing awareness to the fact that like, the tongue is supposed to live in a certain place and, you know, that's. We have the tongue trainer, as we call her in the story, the myofunctional therapist. And so it just kind of takes the whole idea of myo and we have a fun little like, poster that's seen throughout the story that has our little myo superpowers on it. Because, you know, let's bring in a whole superpower theme here. Superheroes. But it says like myo superpowers. Tongue up, lips closed, teeth apart, breathe through your nose. And like, that's constantly what I would say to my own kids. That's what I say to the kids that I was working with as a myofunctional therapist. And it's really, it's establishing that closed mouth posture that's relaxed, that nasal breathing, the tongue living up in the roof of the mouth and then, you know, getting rid of any habits or, you know, not so ideal patterns or, you know, whatever might be present. So.

Because again, the tongue is, you know, it's a very powerful group of, group of muscles, as you and your providers know, obviously. But it's, it's like nature's retainer. If you can get it up to that roof, whether it's post expansion or growth appliance therapy or braces or whatever it may be. I mean, that's amazing. Like, that's, I mean, and then a lot of times I tell people, like, if you can make these behavioral changes during the day, they can often translate into night. So like, I do wear appliance at night, but I wake up and my tongue is at the top. Like, and which is amazing. But I will say about, like, I just want to touch base about something. Like, you have amazing providers that work for you. My son sees one of them. And I will say, like, I think going back to what we said about the parent, maybe the parents doing like a little bit of the introduction of like, where the tongue is or what's going on, like, trying to get the child a little bit, like, warm to the idea. But then, like, if you have a great provider, they're going to take over from there. So I don't want the parents to feel, like, so pressured. Like, oh, you have to diagnose, you have to identify, you have to do all these things. It's not. It's. Sometimes you don't even really have to have the conversation. You could have the conversation with the provider, whether it's dental or myofunctional therapist. You don't necessarily need to have the conversation with your child, you know, Nice. And I will say, like, your specific provider that works with. With Mo, like, she makes things fun. Like, he'll come home with, like, whether it's a little game or when she was helping him to, like, blow his nose, like little things, like a sticker on the nose, like, just fun stuff that, like, they don't even. They don't even think of it as quote, unquote, therapy. They don't even think of it as work. They're like, oh, yes, I get to see, you know, Sam today, for example, you know.

Yeah, yeah, well. And I think that's what makes a great therapist, too. Someone who's like. And I always say it's like a dance between art and science. There's obviously the science behind what we're doing, but then there's the art of standing on your head when you work with children and keeping them entertained and making it fun. And, like, if you're exhausted at the end of the day because. But those kids had fun and, like, they did what you intended for them to do. Like, you did your job and you did it well, you know, and so I think that, like, like, to your point, you got to make it fun. You got to empower the kids. Like, you got to make the kids want to do it. Like, if they're not interested, like, well, you're not going to get anything done, you know, for adults. So true, so true. Like, when you make things, like, clinical and scary and like, super serious, people are just like, okay, let's go through the motions, you know? But when you're kind of like, laid back and you just like. And I think it's really important too, like, even in a young child, to connect it to something they care about, right? So, like, if they like stickers, like you're saying you put a sticker on the nose or a little note or whatever, they, like a superhero, you know, you can print off A coloring sheet and be, you know, and talk about their mouth.

Yeah.

Oh, look, your mouth is like Superman's or whatever.

You know, it's like a chart. Like, okay, they did their myoes they get to color in the star. I mean, you know, it's just. I mean. And also sometimes it's just a matter of like, depending on your child making. Making it make sense to them. Like, when Mo started expansion, he was like, ah, why do I have this thing? What's going on? And I said, your palette's like this. We want to make it like this. So he's like, oh, okay. And then now he'll ask me, is it still like this? I'm like, well, it's getting better, you know, but like, sometimes the kids just. If you just like, make simplify, they.

Make it, you know. Yeah, exactly. And it's like people get so hung up in, like, things being so accurate or so, like, pretty. Take a piece of like, play doh and make a little model and be like, it looks like this and we want to like this. Just exactly what you were just talking about. And kids are just gonna be like, oh, okay. Like, what do they have to compare it to?

Like, Gabby just saw Leah, Lily and Mia's cases, like, sorry, combined with Lily and Mia's, and she was like, wait, I wanna, I wanna case like that for my appliance. I'm like, sure, no problem. Like, it's a pink and purple case that gets her excited.

By all means, you can have all the pink and purple cases. Yes. Ordering now. Yes. So funny. I love that. Okay, so then to kind of transition us into the third book. Let's get your tongue unstuck. Let's talk about like the. And then we kind of touched on this earlier, but like, the importance of a release and also preparing for that release just kind of just piggyback on the timing of release, timing how to make it not so scary. Like, do you have any, any tips there?

Yeah, so I think, you know, as long as they're working with a provider and they have the exercises on board before and after, that alone is setting you up for success. Because you don't want to do a release and there's no exercises on board. And then all of a sudden, like, I think you may have talked about, like, where is it going to go? You know, where is it going to live? Is it going to end up wanting to live in the floor versus the roof? I mean, you have to give the tongue the tools to be able to succeed. And I think by getting the myofunctional therapy on board before the release. The kid's already familiar with this. So then they go in to do the release. And as long as you don't have someone making it scary for you, like, oh, you know, you're gonna have to get a shot. Like, don't say that. Don't just, you know, sometimes less is more in terms of what you tell them. Because, look, a lot of people have dental anxiety. We see it all the time. You know, like, when I had my own root canal tooth removed, I. I had some sedation. I totally get it. Don't get me wrong. But a lot of times, like, if. If the kid senses, like, your fear and it's. And it's. It is normal, because my kids have gone through things, and I'm, like, secretly freaking out, and I'm like, okay, just stay calm. You know, Stay calm for them. You know, they'll. They'll feel your calm energy. But at the same time, like, you also, if you want to do prepare that, like, want to prepare them, that makes sense, too. So, like, if you want to talk about, like, the shot, for example, you like the local anesthetic, you could say, okay, it's going to feel like a little, like, pinch or a little bug bit or what. However you want to say it. And then we talked about in the book, like, using the magic light, like, that is a laser to release the tissues. And honestly, it's not a very long procedure. So, you know, especially, like, my kids were released pretty young. Like, I think Gabby was two weeks old and Mo was one week old. They were both born with severe lip ties. In that case, since they were so young, it was like topical anesthetic. Wipe it on, wipe it off, use the laser. And we were like, in and out and probably like half an hour, like, start to finish. So it also depends on the age. That's a big, you know, because if they're a little older, you may want to prep them a little bit more and just use gentle language. I mean, what have you guys found with your therapists? And are they talking to them about the procedure or not so much.

Yeah, I mean, I think we try to understand, like, who the release provider is. You know, obviously we know your team just understanding, like, how things are going to happen. And I think it depends on the kid. Like, some kids could walk in completely, pretty much blind to just be like, you know what? We're gonna go, and they're gonna use this thing, and it's gonna look like this pen kind of. But It'll be silver. And they're gonna go. And it's gonna feel a little funny. They're gonna make it so that your tongue can move. And, like, that's it. We don't say, oh, they're gonna go, cut the tissue. You know, like, you can't say things like that to kids, even talking about that with adults. Sometimes you can see adults, like, tense up, right? And so I'm like, obviously with an adult, like, we'll have a, like, more straight up conversation when they're asking us questions. But we try to kind of like make it so it doesn't feel like such a mystery. But at the same time, it's like, let's also calm your nerves because, like you said, like, we want the parent to be calm because the child's gonna reflect whatever the parents are.

You don't want in fight or flight when they're coming in. Like, you just want totally relaxed. And, you know, I think also, you know, it also depends, like, maybe, you know, some people are using a little bit of sedation, the nitrous or not. So in that case, like, may not really need to tell them anything. And like, you're saying, like, sometimes you. You do want to just share, like, oh, it's gonna be like a little pen. Or sometimes it's like, like, I remember Gabby's first, like, blood draw, and I was just like, we're just gonna go with it.

Yeah, yeah. How do I explain? Oh, you're gonna have a needle in.

Your heart taking blood out.

Yeah. You're like, close your eyes and squeeze my arm real tight. Yeah, yeah. Hold you real tight so that you don't injure yourself when they do this.

Okay, cool.

Yeah, no, no, I think, and I think, like, to your point too, like, we once upon a time, in our early days, did not require, like, pre op. And we see such a big difference between the kids and adults who get the pre operative myofunctional therapy or feeding therapy or whatever therapy it is to prep the tissue. Plus, body work is always beneficial, too, because, like, when you're. When you have all these tension patterns in the orofacial complex, it carries to other parts of the body. Right? It's all interconnected. There's all these compensations happening. And so we see the best results with anybody who is taking that team approach. Right? Like, they're working with you, the dentist, they're working with us for the myo or the feeding or the combination. Then we've got the family as part of that team, too. And then Any other providers who might be involved. But I think what's really important is to have the parents, like, go in. If they're going to have to do active wound care, like, let's say there's no sutures. They're going to be elevating that tongue however many times a day. You know, we need them feeling so dang good about it when they go to the release appointment, like, they're not seeing it for the first time, trying it for the first time, because I can tell you, like, 99% of those parents are either not going to do it well or they're not going to do it at all because they're too scared and they don't want to hurt their child. And they're. They're not feeling prepped, they're anxious, and they're like, you know what? We'll just go back to the dentist.

In a week, and they can just.

Do whatever they need to do. You know what I mean? So, yeah, like, we like to be like, okay, mom or, okay, dad. Okay, caregiver. Like, how are you feeling? Like what? Like, show me and I'll even. I used to have them do it on me. I'd be like, do it on me. I want to feel that, like, you know, like, what you're doing, and that way I can say, okay, go a little harder. No, like, you're not going to hurt me.

Yeah. You know what I mean?

And so that way, I feel like the parents feel, like, really, like, ready. And like. Like. Like they're. They're ready to go. They feel good. So then the kids feel good, like.

Even going back to something said about, like, the play. D'oh. Like, make a model. Have them practice. They can see how hard. Totally. I mean, because when some. When you. Sometimes when you learn how to suture, you're, like, doing it on, like, a tomato, where. This is very thin, like, those. Those just different ways to bring the message home. Yes. Is great.

Yeah. And then, like, even the kid, depending on their age, like, having them do it on the parent, and then the parent do it on them, you know, so it's sort of just like if you get a kid, sometimes there's. Kids are just like, whatever you want. Then you get kids who are like, absolutely not. Don't come near my face. This hurts. Right? Or I know this feels funny. So, like, we will sometimes tell kids, you know what, your tongue's gonna feel a little funny after. And so we're gonna eat fun things. You're gonna get, like, a popsicle. And because we know the cold feels good and it's easy to swallow the liquid or just, you know, we. So we kind of have something fun for them to, too. I mean, I remember, like, when I had my tongue tie released and I didn't have any sutures placed, but I went home that night and I ate. Don't ask me why, but in my brain I was like, this seems like a good idea. I ate oatmeal.

Yeah.

It took me 45 minutes to eat, like, a half a cup of oatmeal. It was ridiculous. I was like, okay, this was a horrible idea. Clearly not the first meal I should have had. And. But it was also a really good learning experience.

And now I can tell parents I did this. I went, like, out to dinner and had, like, a salad. I'm like, what am I doing? I can't eat this right now.

Yeah, I know.

So. But no, I mean, and also, like, pain management, too. Like, if, you know, maybe there'll be a little pain, maybe not just depending on, like, how restricted somebody is, but, like, being ahead of that. So, like, if you are into homeopathy, using some arnica, for example, before the procedure, like, you know, and obviously the provider needs to look at the medical history, the dental history, you know, talk about, like, significant medical conditions and the allergies, any current medications, supplements, all those things that are more than likely already discussed. But, you know, a lot of times if you just get ahead of the, A, the pain management or B, like, sometimes if they're a little numb, whether it's like, for this or filling or whatever it may be when I do, like, my dental mission trips and the kids, like, there's a language barrier and they don't understand. Like, I'll show them in my phone. Like, look, you. Everything looks normal. Because it's a lot of times that funny feeling that it's like fat or swollen, but it's really. It looks fine. And then the kid will say, oh, okay, you know?

Yeah, yeah, No, I love that. I feel like it's that awareness, right? You're being in and that. That body just understanding what's happening to their body. Because I think again, it calms the nerves. Like, if you can just see that, everything looks okay. Oh, okay. Because, like, what you feel and what you see, right? Your senses are totally going to be so different until you marry them together. So I love that.

And I think.

I think that kind of ties into, like, some of, like, the themes that I think go throughout the books, right? Like, this whole concept of self awareness that you brought up just understanding your body and understanding how to talk about these things once you're, you know, it's age appropriate overcoming like fear. Right. Because I think some of these things can feel a little scary. And so I do feel like it's our job as a providers to help parents feel calm like you said, because the kids are going to feed off of the parents nervous system and if the parents are calm, the kids will be calmer. So yeah, I just, I think those things are so, so very important. I do feel like we did a really good job of kind of like you know, intertwining that throughout these books.

And I see like my patients that have been getting them. Like I had one today and she's like my like daughter who just had a baby, like is making like the baby's making a sound during nursing. And I was like, you should use these, you know, like, because like whether it's a grandma with a mom who just had a baby, you're like trying not to like step on toe, you know, whatever it may be. It's a very also like a gentle way just to like hey, my dentist wrote these books. Yeah. Like so it's just, it's very cool because it's parents like you said providers like putting them in the waiting rooms, you know, giving them to the kids. Bring like I brought it to Gabby school, most school. It's just, it's so many people can use them. Grandpa's grandma, you know, it's, it's great.

Yeah. And I think it also helps with like, because we're kind of showing collaboration in the books amongst providers and I think that's important to demonstrate because I know we talk about it a lot but I don't think parents understand. Half the time parents come to me, they're like, well, who do I see first? And I don't think they understand that we can work together. Right. And sometimes if you go to the dentist first or you go to the myotherapist first or you go to the body worker first, like those of us who are actually collaborating, like we're going to send you to the next person that we believe is going to be the best for your case and, and we're going to communicate with them. So I love that like we kind of naturally like worked that into the.

Book and I think, I think it's. Sorry. And I think that's, I want to just like have a moment of like appreciation for this like team approach to care. Because when you and I first started doing this like a Million years ago, there wasn't that. And like, you and I had started like that study club where we were like each month reading, like a cool, nerdy, like, medical book or whatever, you know. But I feel like the other day I had. Or maybe like maybe a month ago at this point, I had a referral from a child psychiatrist.

Oh.

Because they had been talking to the parents about sleep. Because a lot of times is like, going a little off topic, but sort of in all of this airway space, it's like children, if they're not sleeping well, and whether it's the tongue position or whatever enlarged adenoids or whatever it may be, they're not sleeping well. Us adults, we compensate, drink coffee, take a nap, whatever. Kids, it comes out as either like really tired or hyperactivity. And other countries, like, before you can even think about these, like, ADHD meds or anything like that, like, kids are getting sleep studies, they're being about airways being evaluated. That's not going on. I mean, and that needs to happen. Like here we need. In the US we need to be talking about airway. And I think this is also a nice way to introduce some of that because it's all part of the airway. Your mouth, you need it to breathe. Your nose, like, all that. I mean, you're reading your nose, but you know what I mean, in terms of the mouth, you know, but it's all connected. And so I just, I just wanted to take a moment of appreciation, thank all the providers that are treating as a team, because it's, it's really, it's a great thing. It's beautiful. It's really helping so many people that maybe it didn't help before.

Yeah, well. And I think the more that this happens, the earlier we find these kids, the earlier they get the help that they need so they can thrive. Yes. And, you know, it's like there's already stuff going on. We don't need to wait for it to snowball to the point of it being like, so the kid is so off kilter that, like, we're in like totally just, you know, survival mode. Right.

Is like, like, you know, it's one thing if you need to do some things to restore, you know, but like, if I feel like if you see these kids in their formative years, they're like, they're, they're able to function so much better. Like, it's all about function and obviously form. But form influences function and function influences, like all those things are intertwined. And I mean, I just feel like that's part of what this book brings into light is like, okay, what is the function right now? What is the form? You know, it's. Yeah. So, yeah.

Thank you.

I appreciate. I love working with you and your team.

I know, it's so funny. It's like, who would have known when we were in like second grade together, but this is where we would be right now. I love it. I love this for us. Yeah. But I share the.

Our kids because the youngest, like going in second or whatever, like, it's the generations. We're passing it on.

It's so cool. And it's really cool because it's like our kids are in appliances. We're practicing what we preach. Like, you know, they've gone, they've early airway intervention and all the fun stuff. And you know, it's. I just. Yeah. I keep hearing from other providers who have purchased the books or that were at one of our book signings that like, they're like, I put it on the coffee table in my waiting room. Everyone's loving them. And so just a little, like a little plug. If you guys don't have the books yet, like, go to Amazon. You can either type in Dr. Dr. Jennifer Tippograph or Hallie Balkan. Either of our names will pull up the three books and put them on the table in your waiting rooms. Share them with your families. You know, you can even use them in your therapy sessions if you want to. Because I know some, like SLPs, for example, will read books in their therapy sessions as part of the session and everything. And so these are really great. They're not heavily therapeutic. Like, it's not going to require the kids to do a lot, but it'll be really playful and get the kid like. Like we were talking about that. Build that self awareness and kind of figure out what's your tongue doing so really good, like introduction, I think to that for. For young kids especially and then parents, like, having these at home on your bookshelf is not a bad idea because the more the kids are talking about it, the cooler it becomes. And then like, if it's your kid who needs expansion or braces, then it's like totally normalized and it's not the weird thing anymore. Like, Lily came home and she's like, mama, um, two girls in my class have braces and one boy got an expander, but it doesn't look like mine. And I was like, okay. You know, and like, it's just. She was excited about it because other kids were basically doing what she's doing. And she wasn't alone in it. And it's like, I think we forget as parents that, like, yes. You know, these expansion appliances can seem like a normal part of child development.

Yeah.

But in the airway space, it's a little bit different than in your traditional, like, ortho approach. And so, like, while braces maybe become a little bit normalized, like, my goals for my kids to not need races because of what we're doing. So let's normalize that conversation where the kids have expanders and Invisalign.

Yeah, absolutely. Yeah.

So I love. I loved that when she came home, I was like, oh, this is cool.

Because she's, like, looking at the kids.

And being like, oh, they're like me, that, like. Like, we have this similarity, which is very, very cool. So. All right, so let's start to wrap this up a little bit. People have asked, like, are you going to write more books? Are there other topics? And I'm like, oh, my gosh, we literally just launched these. But I know you and I were talking. We're like, there are so many different things.

Potentially even talking to you right now, I'm like, oh, I have another.

I know. I was sitting here and I was like, infant. Yes. Okay. Infant symptoms. Yes. That's not covered in this book. Yeah, I know, I know. We'll chat, but we shared where to find them and listen. I mean, I would love to hear from you. So if you have your own journey and a tongue journey or whatever for your child or you, you can always reach out to, you know, either one of us. Jen, tell them where they can find you on Instagram.

So I work at a practice. It's called Natural Dentist Associates Instagram. I'm @Doctor Dr. Jennifer Tippograph. And then, you know, if you want to just go online and check out the practice or you have any questions, you can just message me. I'm happy to chat. I love this stuff. So happy to talk anytime. Thank you.

Awesome. And we'll put that all in the show notes, too, so they can easily click through to the practice and to the Instagram. Instagrams and everything. Let me think if there's anything else. Any last thoughts before we start to wrap up?

There's so many things I want to, like, talk about, you know, but it's. It's just, you know, keep smiling, you know, it's brush your teeth, all that fun stuff. You know, we don't want to forget about those little things. But talking about, like, the. The ph changes, and then I think one thing I feel like in the past, I'm like, here's my psa. No extraction of adult teeth.

Yes, one of those.

I mean, obviously, like the wisdom teeth, you know, the third molars. Even though the research now shows if you have room for them, they're not infected, impacted, or decayed to keep them. But unfortunately, I'm still seeing people being, you know, recommended for premolar extractions to create more space. There's other ways to do it now.

Yeah.

So I feel like that's like, my psa. Yeah.

Because, hi. As an adult, I'm over here going like, I had my wisdom teeth out. I had two that were impacted, two that weren't. They pulled all four when I was in high school. And I feel like I've spent, like, half my adult life trying to open my airway by. Through expansion because, you know, which would have been easier had I still had those four teeth there. However, here we are. So on that token, because I feel like parents may ask me. Just had a conversation with a friend yesterday, like, leaving Pilates. Yeah. Her son had a. I guess one of his molars, I guess, pulled out. It's a baby tooth, though, because it was causing pain. They said there was a tooth that was, like, kind of growing in sideways or something, and the kid's like, five, so they ended up pulling the tooth out. Now the child is going for expansion to a recommended provider, like, soon. So that's not the provider they saw. But I was like, okay, the child will be okay. But you mentioned, like, adult, like, permanent teeth. Now, do you have thoughts on, like, pulling baby teeth?

So it depends. I mean, obviously, if it's like, the baby tooth is infected or something's going on where, like, you can't save it, like, by all means, you have to do what you need to do. And, like, you know, but you want to maintain that space. So ideally, if they're going to do growth appliance therapy or expansion, whatever you want to call, ideally, that will be able to hold the space, because back in the day, it was like, oh, space maintainers. Space maintainers. But for some of my patients that I'm doing an expander on, it will help. It will help to maintain that space. So the last thing you want is for that space to be close and then block the permanent tooth from coming in. Yes. Yeah.

Okay. Beautiful. Love that. Thank you. Just was like, it randomly popped into my brain, and I was like, yeah, this is interesting. Yeah. And then one last thing, like, to your point, too. So you had mentioned that, like, your tongue is Your natural palate expander. And if we can get that tongue up in the roof of the mouth, like whether it's not up there now, but you get expanded and then myo to have the tongue up there, like it will hold your expansion. I wanted to highlight that because I feel like I was an adult, like ortho relapse case. I've had so many other adults I've worked with that have had orthodontic relapse, meaning that like everything kind of collapsed back after having expansion or braces because the tongue was either pushing up against the teeth, through the teeth or was sitting low in the mouth. It was not actually like living on the roof of the mouth holding that new beautiful U shaped wide palette. Right, right. And so that's like, I always like to highlight that for people because a.

Lot of people are like, what?

Oh, well, I was expanded when I was a kid and I'm looking at their mouth and I'm like, but you look pretty high and arrow to me. And you're saying you've got all these symptoms. So I know this is a kids series, guys, but like this applies across the lifespan. So that's. I just wanted to plug that.

Yeah. Thank you. Yeah. Yeah.

Well, thank you so much for hanging out today. I'm excited to get these books just out there in the world more. And who knows, we'll have to see if we come out with any others.

Thank you.

Thanks for listening to this podcast. If you found value in this episode and want to hear more of these Myotots, Airway and Feeding related episodes, be sure to leave a review on Apple Podcasts and share this episode on your social media platforms. You can access free resources and all I offer@hbkin.com or pop over to Holly Balkan on Instagram to get all the latest updates.